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1.
Microsurgery ; 44(1): e31126, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37990820

RESUMO

BACKGROUND: Radial forearm free flap (RFFF) donor site closure is traditionally performed with split thickness skin grafts (STSG), which can be associated with poor aesthetics, wrist stiffness, paresthesia, reduced strength, and tendon exposure. Full thickness skin grafts (FTSG) are potentially beneficial as they provide a more durable coverage, and the skin graft donor site can be closed primarily, which is more aesthetic. The aim of this systematic review is to compare the outcomes of STSG versus FTSG for closure of the RFFF donor site. METHODS: A systematic review was performed, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The primary objective was to answer: do subjects undergoing RFFF harvest, utilizing FTSG to close the RFFF donor site, compared to STSG, achieve superior aesthetics at the RFFF donor site? Included papers compared FTSG and STSG with statistical data. Means were compared with t-test and proportions with Fisher's exact test. RESULTS: The initial search resulted in 1851 studies. After applying the inclusion/exclusion criteria, the search resulted in eight studies, with 366 total skin grafts, 197 STSG and 169 FTSG. Six studies evaluated aesthetics utilizing a Likert scale, with the scaled average aesthetic score for FTSG being 7.9/10 compared to 6.9/10 for STSG (p < .001). Tendon exposure was measured in five studies, with a rate of 13.1% for STSG versus 10.6% for FTSG (p = .555). No significant difference in function was observed, however, methods to quantify function were heterogeneous. CONCLUSION: FTSG compared to STSG, resulted in statistically significant improved aesthetics, with comparable rates of tendon exposure and function.


Assuntos
Retalhos de Tecido Biológico , Procedimentos de Cirurgia Plástica , Humanos , Transplante de Pele/métodos , Retalhos de Tecido Biológico/transplante
2.
Arch Toxicol ; 97(2): 405-420, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36424514

RESUMO

Silver nanoparticles (AgNP) are the most widely produced type of nanoparticles due to their antimicrobial and preservative properties. However, their systemic bioavailability may be considered a potential hazard. When AgNP reach the bloodstream, they interact with the immune cells, contributing to the onset and development of an inflammatory response. Monocytes and macrophages play a pivotal role in our defense system, but the interaction of AgNP with these cells is still not clear. Therefore, the main objective of this work was to assess the cytotoxic and pro-inflammatory effects induced by 5, 10, and 50 nm AgNP coated with polyvinylpyrrolidone (PVP) and citrate, in concentrations that could be attained in vivo (0-25 µg/mL), in human monocytes isolated from human blood and human macrophages derived from a monocytic cell line (THP-1). The effects of PVP and citrate-coated AgNP on cell viability, mitochondrial membrane potential, and cytokines release were evaluated. The results evidenced that AgNP exert strong harmful effects in both monocytes and macrophages, through the establishment of a strong pro-inflammatory response that culminates in cell death. The observed effects were dependent on the AgNP concentration, size and coating, being observed more pronounced cytotoxic effects with smaller PVP coated AgNP. The results showed that human monocytes seem to be more sensitive to AgNP exposure than human macrophages. Considering the increased daily use of AgNP, it is imperative to further explore the adverse outcomes and mechanistic pathways leading to AgNP-induced pro-inflammatory effects to deep insight into the molecular mechanism involved in this effect.


Assuntos
Citocinas , Nanopartículas Metálicas , Humanos , Monócitos , Prata/toxicidade , Nanopartículas Metálicas/toxicidade , Potencial da Membrana Mitocondrial , Macrófagos , Povidona/toxicidade , Citratos/farmacologia , Ácido Cítrico/toxicidade
3.
Oral Dis ; 2023 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-38069546

RESUMO

BACKGROUND: Lichen planus is one of the common adverse reactions after COVID-19 infection and vaccination. Despite it being reported in several case reports, the literature including a large sample of the studied population is lacking. The current study was performed to assess the risk of LP after COVID-19 infection as well as COVID-19 vaccination. METHODS: The current study was designed as a retrospective cross-sectional hospital-based study of registered patients at the University of Florida (UF) health centers. The diagnoses of LP, COVID-19 infection, and COVID-19 vaccines were detected. The logistic regression model was used to assess the risk of developing LP after COVID-19 infection and vaccination. RESULTS: A total hospital patient of 684,110 attended UF Health centers were included in this study. 181 patients reported LP after COVID-19 vaccination and 24 patients developed LP after COVID-19 infection. The risk of developing LP after COVID-19 vaccination was 1.573 while the risk of developing LP after COVID-19 infection was 1.143. CONCLUSION: The odds of getting LP after COVID-19 vaccination are significantly developed. The current study showed that COVID-19 infection and vaccination are associated with LP. So, healthcare practitioners should be aware of this reaction for rapid recognition and treatment.

4.
J Oral Maxillofac Surg ; 81(9): 1170-1175, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37343935

RESUMO

BACKGROUND: Free tissue transfers for reconstruction following tongue resection has become standard practice. PURPOSE: This study sought to evaluate volume shrinkage of the anterolateral thigh free (ALTF) reconstructing tongue defects at 6 months postoperative. The aim was to estimate a shrinkage factor for ALTF reconstructing hemi and total glossectomy. STUDY DESIGN, SETTING, SAMPLE: This was an IRB-approved retrospective cohort study conducted at the head and neck service at the University of Florida, College of Medicine, Jacksonville (FL). This study targeted patients with tongue cancer from January 2018 to April 2022. INCLUSION CRITERIA: patients with tongue squamous cell carcinoma (SCC) who were surgically treated by either hemi or total glossectomy and reconstructed with ALTF. Patients had to have a postoperative computer tomography scans at 1 and 6 months post-surgery. Patients with constant body mass index during 6 months postreconstruction. Additionally, the patients were to have been treated with adjuvant radiotherapy. EXCLUSION CRITERIA: patients with recurrent tongue cancer and those who weren't reconstructed or managed with other treatment modalities. PREDICTOR VARIABLE: Type of tongue resection hemi versus total glossectomy for treatment of tongue SCC. MAIN OUTCOME VARIABLE: Shrinkage percentage of ALTF reconstructing tongue defects at 6 months postoperatively. COVARIATES: Age and gender. ANALYSES: Paired t-test and student t-test with level of significance P ≤ .05 were used to statistically analyze ALTF volume changes at 1 and 6 months postoperatively and ALTF shrinkage percentage at 6 months postreconstruction, respectively. RESULTS: We identified 85 patients who were treated for tongue SCC during the time period of study. Out of the 85 patients, 11 patients were reconstructed with an ALTF. Eight males and 3 females with a mean age of 62.3 years old. Six patients had total glossectomy and 5 had hemi glossectomy. Patients with hemi glossectomy had a significant difference in mean average flap shrinkage of 39.6%, while in those with total glossectomy had 17.7% (P = .004). CONCLUSION AND RELEVANCE: According to our results, we recommend that the flap size should be larger than the defect to adjust for volume shrinkage (1.4 times and 1.2 times for cases of hemi and total glossectomy, respectively).


Assuntos
Carcinoma de Células Escamosas , Retalhos de Tecido Biológico , Procedimentos de Cirurgia Plástica , Neoplasias da Língua , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Retalhos de Tecido Biológico/cirurgia , Glossectomia/métodos , Neoplasias da Língua/cirurgia , Carcinoma de Células Escamosas/cirurgia , Estudos Retrospectivos , Recidiva Local de Neoplasia/cirurgia
5.
Molecules ; 28(3)2023 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-36770886

RESUMO

In recent years, lycopene has been highlighted due to its antioxidant and anti-inflammatory properties, associated with a beneficial effect on human health. The aim of this study was to advance the studies of antioxidant and anti-inflammatory mechanisms on human keratinocytes cells (HaCaT) of a self-emulsifying drug delivery system (SEDDS) loaded with lycopene purified from red guava (nanoLPG). The characteristics of nanoLPG were a hydrodynamic diameter of 205 nm, a polydispersity index of 0.21 and a zeta potential of -20.57, providing physical stability for the nanosystem. NanoLPG demonstrated antioxidant capacity, as shown using the ORAC methodology, and prevented DNA degradation (DNA agarose). Proinflammatory activity was evaluated by quantifying the cytokines TNF-α, IL-6 and IL-8, with only IL-8 showing a significant increase (p < 0.0001). NanoLPG showed greater inhibition of the tyrosinase and elastase enzymes, involved in the skin aging process, compared to purified lycopene (LPG). In vitro treatment for 24 h with 5.0 µg/mL of nanoLPG did not affect the viability of HaCaT cells. The ultrastructure of HaCaT cells demonstrated the maintenance of morphology. This contrasts with endoplasmic reticulum stresses and autophagic vacuoles when treated with LPG after stimulation or not with LPS. Therefore, the use of lycopene in a nanoemulsion may be beneficial in strategies and products associated with skin health.


Assuntos
Antioxidantes , Interleucina-8 , Humanos , Licopeno , Antioxidantes/farmacologia , Sistemas de Liberação de Medicamentos/métodos , Anti-Inflamatórios/farmacologia , DNA
6.
J Immunol ; 203(9): 2485-2496, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31562210

RESUMO

Anemia is a frequent and challenging complication of mycobacterial infections. We used a model of disseminated Mycobacterium avium infection in mice to investigate the mechanisms of mycobacteria-induced anemia. We found increased formation of RBC in the bone marrow and spleen of infected mice. Infection induced reticulocytosis and the premature egress of immature progenitors to the systemic circulation in an IFN-γ (IFNG)-dependent way. The newly formed RBC had reduced CD47 surface expression and a reduced life span and were phagocytosed in the liver of infected mice, increasing iron recycling in this organ. The increased engulfment and degradation of RBC was independent of IFNG sensing by macrophages. Together, our findings demonstrate that mycobacterial infection alters the formation of erythrocytes, leading to their accelerated removal from circulation and hemolytic anemia. This comprehensive elucidation of the mechanisms underlying mycobacteria-induced anemia has important implications for its efficient clinical management.


Assuntos
Anemia/etiologia , Eritrócitos/fisiologia , Interferon gama/fisiologia , Infecções por Mycobacterium/complicações , Animais , Células da Medula Óssea/citologia , Antígeno CD47/análise , Diferenciação Celular , Eritropoese , Hepcidinas/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Infecções por Mycobacterium/sangue , Fagocitose
7.
J Oral Pathol Med ; 49(2): 150-155, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31732985

RESUMO

BACKGROUND: Venous invasion (VI) is not frequently evaluated on routine histologic examination of head and neck squamous cell carcinoma (HNSCC), and the prognostic significance is largely unknown. Studies have shown that extramural venous invasion is an adverse prognostic factor in colorectal carcinoma. To our knowledge, this is the first study evaluating the prognostic significance of venous invasion in node-negative (without clinical or pathologic evidence of lymph node involvement) HNSCC, utilizing the elastic stain. METHODS: A total of 105 consecutive lymph node-negative (N0) HNSCC were evaluated for the presence of venous channel invasion by tumor utilizing the elastin stain. Clinical, demographic, and follow-up data were recorded. RESULTS: Of 37 patients with venous invasion, 19% had loco-regional recurrence, as opposed to 12% of those without. Univariate analysis revealed statistically significant decreased recurrence-free survival in the presence of venous invasion (log-rank [Mantel-Cox] test P-value .025). CONCLUSION: Identification of VI is greatly aided by elastic stain. In patients with node-negative HNSCC, presence of VI resulted in decreased recurrence-free survival on univariate analysis. The impact of VI as a prognostic marker should be further evaluated.


Assuntos
Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas de Cabeça e Pescoço , Humanos , Metástase Linfática , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prognóstico
8.
J Oral Maxillofac Surg ; 77(8): 1703.e1-1703.e6, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31009633

RESUMO

Recent innovations in wearable action cameras with high-definition video recording enable surgeons to use cameras for their surgical procedures. In this study, the GoPro HERO 6 (and 7) Black edition camera was modified step by step to allow for a completely wireless surgeon-perspective recording with a battery life and memory capacity never previously obtained with such a high level of digital video quality. With this system, a surgeon can record for more than 14 hours 26 minutes in 1,080 pixels at 60 frames per second without breaking scrub and capture the operating surgeon's direct view of the field. By modifying the newest generation of devices, the authors successfully eliminated all shortcomings of the prior generation of GoPro cameras for surgical recording. The modified GoPro HERO6 camera produced professional recording quality for a total cost lower than US$850. This is critically important, because video-based surgical training will continue to be a primary area of development in the future and represents a novel and effective way for young generations of surgeons to attain technical excellence and knowledge in surgery.


Assuntos
Cirurgia Bucal , Gravação em Vídeo , Humanos , Período Intraoperatório , Cirurgiões Bucomaxilofaciais , Garantia da Qualidade dos Cuidados de Saúde , Cirurgia Bucal/normas
9.
J Oral Maxillofac Surg ; 76(1): 229.e1-229.e9, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28797674

RESUMO

In recent years, there has been a paradigm shift in mandibular reconstruction, especially for benign disease, using computer technologies to achieve improved cosmetic and functional outcomes. In this case series, the authors review their experience with computer-guided planning to achieve improved esthetics. They also review the current literature on recent advances.


Assuntos
Ameloblastoma/patologia , Ameloblastoma/cirurgia , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/cirurgia , Reconstrução Mandibular/métodos , Cirurgia Assistida por Computador , Adolescente , Ameloblastoma/diagnóstico por imagem , Feminino , Retalhos de Tecido Biológico , Humanos , Masculino , Neoplasias Mandibulares/diagnóstico por imagem , Pessoa de Meia-Idade , Radiografia Panorâmica
10.
Food Microbiol ; 76: 416-425, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30166169

RESUMO

The application of lytic phages as biocontrol agents is emerging as a promising strategy towards elimination or reduction of foodborne pathogens in a variety of food products. This technology is particularly advantageous for minimally processed and ready-to-eat (RTE) foods. In this study, the potential use of Listex™ P100 combined with high hydrostatic pressure (HPP), to enhance the control of Listeria monocytogenes in food was evaluated. For that, the effect of three pressures (200, 300 or 400 MPa; 5 min, 10 °C) on phage P100 stability was tested when inoculated in six different matrices: phosphate buffered saline (PBS, pH 7.4); apple juice (pH 3.41); orange/carrot nectar (pH 3.54); UHT whole milk (pH 6.73); and, two traditional Portuguese fermented products, "Serra da Estrela" cheese (pH 5.66) and "Alheira", a meat sausage (pH 6.07). The results showed that treatment at 400 MPa reduced phage titres to below the detection level in all matrices, whereas at milder pressures the survival of the phage was matrix dependent. "Alheira", "Serra da Estrela" cheese and UHT whole milk were shown to be baroprotective matrices that support phage P100 application in HHP up to 300 MPa; however, an accentuated phage inactivation was observed in apple and orange/carrot nectar, which may be related to the acidic pH values of these matrices. The initial phage load did not affect the inactivation rate during HHP processing (300 MPa, 5 min, 10 °C) in PBS, cheese, sausage or milk matrices, and the phage titres were stable in these matrices during storage at 4 °C for 28 days for milk and 60 days for "Alheira" and "Serra da Estrela" cheese. In addition, a baroprotective effect on phage stability was observed when PBS was supplemented with reducing sugars, dextrin, casein, and tween 80. In conclusion, at mild HHP treatment, phage P100 remained active in specific matrices and seems to present potential to be added in non-thermal inactivation of L. monocytogenes.


Assuntos
Bacteriófagos/fisiologia , Queijo/microbiologia , Fast Foods/microbiologia , Conservação de Alimentos/métodos , Sucos de Frutas e Vegetais/microbiologia , Listeria monocytogenes/virologia , Produtos da Carne/microbiologia , Leite/microbiologia , Animais , Contaminação de Alimentos/prevenção & controle , Conservação de Alimentos/instrumentação , Pressão Hidrostática , Listeria monocytogenes/fisiologia
11.
Development ; 141(7): 1553-61, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24598164

RESUMO

Myelination allows rapid saltatory propagation of action potentials along the axon and is an essential prerequisite for the normal functioning of the nervous system. During peripheral nervous system (PNS) development, myelin-forming Schwann cells (SCs) generate radial lamellipodia to sort and ensheath axons. This process requires controlled cytoskeletal remodeling, and we show that SC lamellipodia formation depends on the function of profilin 1 (Pfn1), an actin-binding protein involved in microfilament polymerization. Pfn1 is inhibited upon phosphorylation by ROCK, a downstream effector of the integrin linked kinase pathway. Thus, a dramatic reduction of radial lamellipodia formation is observed in SCs lacking integrin-linked kinase or treated with the Rho/ROCK activator lysophosphatidic acid. Knocking down Pfn1 expression by lentiviral-mediated shRNA delivery impairs SC lamellipodia formation in vitro, suggesting a direct role for this protein in PNS myelination. Indeed, SC-specific gene ablation of Pfn1 in mice led to profound radial sorting and myelination defects, confirming a central role for this protein in PNS development. Our data identify Pfn1 as a key effector of the integrin linked kinase/Rho/ROCK pathway. This pathway, acting in parallel with integrin ß1/LCK/Rac1 and their effectors critically regulates SC lamellipodia formation, radial sorting and myelination during peripheral nervous system maturation.


Assuntos
Bainha de Mielina/fisiologia , Nervos Periféricos/fisiologia , Sistema Nervoso Periférico/fisiologia , Profilinas/fisiologia , Animais , Transporte Axonal/genética , Células Cultivadas , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Neurogênese/genética , Neuropeptídeos/fisiologia , Pseudópodes/genética , Células de Schwann/fisiologia , Proteínas rac1 de Ligação ao GTP/fisiologia
12.
J Oral Maxillofac Surg ; 75(12): 2709.e1-2709.e12, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28893544

RESUMO

Myxofibrosarcoma (MFS) is a malignant fibroblastic tumor that primarily affects the lower and upper extremities. It is usually described as a slow-growing tumor with high recurrence rates but low metastatic potential. The reported incidence of head and neck MFS is 2 to 4% and rarely presents with distant metastases. This report describes a case of maxillary MFS in a 72-year-old woman whose disease progression followed an atypical course with an extremely rapid rate of growth and early pulmonary and central nervous system lesions. The pulmonary symptoms at initial presentation made a final diagnosis a challenge. Various diagnostic modalities and multidisciplinary collaboration were required. The disease course and management are outlined. To the authors' knowledge, this is the first case of MFS originating in the maxillary alveolus with multiple metastases, including the brain and lungs, in the early course of the disease.


Assuntos
Histiocitoma Fibroso Maligno/diagnóstico , Neoplasias Maxilares/diagnóstico , Idoso , Progressão da Doença , Feminino , Histiocitoma Fibroso Maligno/patologia , Humanos , Neoplasias Maxilares/patologia , Metástase Neoplásica
13.
J Oral Maxillofac Surg ; 75(12): 2708.e1-2708.e6, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28886355

RESUMO

PURPOSE: The cervicofacial (CF) flap is a random-pattern flap that provides an excellent match for cheek reconstruction. The design of the CF flap varies between different cheek subunits. In this report, the authors review their experience with this flap and present a guide for flap design for different cheek subunits. MATERIALS AND METHODS: Patients who had cheek reconstruction were screened using the database of the surgical procedures from 2011 to 2016. Seventy-four patients were identified. Data on patient demographics, diagnosis, defect type, and outcome were retrospectively reviewed. Patients who did not have a clear description of the defect or flap design were excluded from the study. The authors divided the cheek into 3 zones and created a guide for flap design for each zone. RESULTS: Twenty-eight patients with CF flap for cheek reconstruction met the inclusion criteria (21 male [75%] and 7 female [25%]; mean age, 57 yr; range, 8 to 88 yr). Fifty-seven percent had zone A defects, 18% had zone B1 defects, 14% had zone B2 defects, and 11% had multiple-zone defects. Mean follow-up was 4.6 months (0 to 17 months). Ninety-three percent had a successful outcome. Only 2 patients developed wound complications. CONCLUSION: The CF flap is a versatile flap that provides excellent skin color, thickness, and texture match in cheek reconstruction. Planning the flap design is essential to achieve a good outcome. The present algorithm provides a straightforward method to reliably design the CF flap for cheek reconstruction.


Assuntos
Bochecha/cirurgia , Pescoço/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bochecha/anatomia & histologia , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/anatomia & histologia , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos , Adulto Jovem
14.
J Oral Maxillofac Surg ; 75(10): 2270.e1-2270.e8, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28697347

RESUMO

The aim of this report is to present a new technique using current technologic advances for immediate reconstruction and dental rehabilitation of segmental mandibular defects with a screw-retained prosthesis. One case is reviewed and a detailed review of surgical and prosthetic techniques used is presented.


Assuntos
Implantação Dentária Endóssea/métodos , Neoplasias Mandibulares/cirurgia , Tumores Odontogênicos/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Humanos , Masculino , Fatores de Tempo , Adulto Jovem
15.
J Oral Maxillofac Surg ; 75(1): 190-196, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27528106

RESUMO

PURPOSE: Clinical pathways have become an important and simple method of improving patient outcomes and decreasing health care resource usage. The purpose of this study was to evaluate early outcomes associated with the implementation of a clinical pathway in a maxillofacial head and neck surgery unit. MATERIALS AND METHODS: This investigation is a retrospective cohort study of patients who underwent microvascular reconstruction of the head and neck from January 1, 2014 through December 31, 2014. Continuous variables were compared among 4 groups using analysis of variance or Kruskal-Wallis test, and categorical variables were compared using χ2 test or Fisher exact test where appropriate. The primary predictor variable was use of the clinical pathway. Groups included patients treated by surgeon A during periods before and after implementation of a postoperative clinical pathway. Two groups treated by surgeon B also were evaluated during the same periods and served as external controls. Each period covered a span of 6 months. Outcome variables across groups were evaluated, including length-of-stay metrics, infection rates, transfers to the intensive care unit, and unplanned return to the operating room. RESULTS: Sixty-six patients who underwent microvascular head and neck reconstruction were included. There was a significant decrease in the average length of stay (P = .0364) and an increase in the rate of discharge within 7 days (P = .0416) in the group treated with the clinical pathway. Other outcomes, including infection rate, transfer to the intensive care unit, and unanticipated return to the operating room, showed no relevant difference among groups. CONCLUSIONS: The results of this study suggest that implementation of a clinical pathway can be beneficial for efficient management of postoperative care in the setting of microvascular head and neck reconstruction. More predictable and shorter lengths of stay are achievable and the clinical pathway serves as a valuable means of improving communication of the clinical care team.


Assuntos
Procedimentos Clínicos , Eficiência Organizacional , Cirurgia Bucal/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Clínicos/organização & administração , Feminino , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Programas , Melhoria de Qualidade/organização & administração , Procedimentos de Cirurgia Plástica/métodos , Estudos Retrospectivos , Cirurgia Bucal/normas , Procedimentos Cirúrgicos Vasculares/métodos , Procedimentos Cirúrgicos Vasculares/organização & administração , Adulto Jovem
16.
J Oral Maxillofac Surg ; 75(5): 984-993, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27888671

RESUMO

PURPOSE: We sought to evaluate clinical-epidemiologic aspects, pathologic characteristics, and treatment of sclerosing polycystic adenosis (SPA) of the parotid gland and to report 2 new cases. MATERIALS AND METHODS: We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for studies published in or before June 2016. The inclusion criteria were as follows: final diagnosis of SPA affecting the parotid gland and articles published in Spanish or English. The exclusion criteria were as follows: unclear diagnosis after pathologic analysis and patients affected by other conditions in the major salivary glands. We added 2 new cases. RESULTS: Our review ultimately included 21 articles and 45 cases. The mean patient age was 41 years (range, 7-84 years). The female-to-male ratio was 2:1. In all patients the tumor showed progressive growth. The evolution range was 7 days to 11 years. In 17.7% of cases, the tumor was associated with pain. The average tumor size was 30.3 mm (range, 12-60 mm). Fine needle aspiration biopsy (FNAB) was unable to diagnose 30 cases. Benign tumors comprised 58% of tumors (18), whereas malignancy was present in 25.8% (8). Thirty-five tumors were well circumscribed. There were 8 multinodular or lobed cases. The tumor was described as encapsulated in 1 case, partially encapsulated or pseudo-encapsulated in 16, and not encapsulated in 12. Five cases showed different degrees of degenerative changes, ranging from dysplasia to invasive carcinoma. All cases underwent surgical treatment. Superficial parotidectomy with preservation of the facial nerve was performed in 22 cases (61.1%), total parotidectomy in 8 (22.2%), and tumor enucleation in 6 (16.6%). The mean follow-up period was 51.5 months (range, 5-276 months). Of documented cases, 74.2% had 2 or more years of follow-up. Recurrences occurred in 6 cases (16.6%). CONCLUSIONS: We consider SPA a benign tumor with progressive growth, which is occasionally painful. It occurs around age 40 years and occurs more often in female patients. Fine needle aspiration biopsy does not provide an adequate preoperative diagnosis. Recurrences are infrequent. Follow-up should be customized according to the pathologic findings. Malignant transformation may occur. Superficial parotidectomy with facial nerve preservation is the treatment of choice.


Assuntos
Doenças das Glândulas Salivares , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Glândula Parótida/patologia , Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/cirurgia , Esclerose
17.
J Antimicrob Chemother ; 71(3): 641-54, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26679255

RESUMO

OBJECTIVES: Broad-spectrum antimicrobial activity of quaternary ammonium surfactants (QAS) makes them attractive and cheap topical prophylactic options for sexually transmitted infections and perinatal vertically transmitted urogenital infections. Although attributed to their high affinity for biological membranes, the mechanisms behind QAS microbicidal activity are not fully understood. We evaluated how QAS structure affects antimicrobial activity and whether this can be exploited for use in prophylaxis of bacterial infections. METHODS: Acute toxicity of QAS to in vitro models of human epithelial cells and bacteria were compared to identify selective and potent bactericidal agents. Bacterial cell viability, membrane integrity, cell cycle and metabolism were evaluated to establish the mechanisms involved in selective toxicity of QAS. RESULTS: QAS toxicity normalized relative to surfactant critical micelle concentration showed n-dodecylpyridinium bromide (C12PB) to be the most effective, with a therapeutic index of ∼10 for an MDR strain of Escherichia coli and >20 for Neisseria gonorrhoeae after 1 h of exposure. Three modes of QAS antibacterial action were identified: impairment of bacterial energetics and cell division at low concentrations; membrane permeabilization and electron transport inhibition at intermediate doses; and disruption of bacterial membranes and cell lysis at concentrations close to the critical micelle concentration. In contrast, toxicity to mammalian cells occurs at higher concentrations and, as we previously reported, results primarily from mitochondrial dysfunction and apoptotic cell death. CONCLUSIONS: Our data show that short chain (C12) n-alkyl pyridinium bromides have a sufficiently large therapeutic window to be good microbicide candidates.


Assuntos
Antibacterianos/química , Antibacterianos/farmacologia , Compostos de Amônio Quaternário/química , Compostos de Amônio Quaternário/farmacologia , Tensoativos/química , Tensoativos/farmacologia , Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/química , Anti-Infecciosos Locais/farmacologia , Anti-Infecciosos Locais/uso terapêutico , Divisão Celular/efeitos dos fármacos , Membrana Celular/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Escherichia coli/fisiologia , Humanos , Metabolismo/efeitos dos fármacos , Viabilidade Microbiana/efeitos dos fármacos , Neisseria gonorrhoeae/efeitos dos fármacos , Neisseria gonorrhoeae/fisiologia , Compostos de Amônio Quaternário/uso terapêutico , Tensoativos/uso terapêutico
18.
J Oral Maxillofac Surg ; 74(11): 2123-2127, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27566985

RESUMO

Oral and Maxillofacial Surgeons have increasing opportunities to train in head and neck oncologic and reconstructive surgery. The development of a fellowship training programs within our speciality has had a transformative effect on the speciality. This survey by the commitee on Maxillofacial Oncology and Reconstructive is aimed to evaluate the impact of fellowship training on the careers of the fellows and speciality from 2005-2015.


Assuntos
Bolsas de Estudo , Neoplasias de Cabeça e Pescoço/cirurgia , Procedimentos de Cirurgia Plástica/educação , Padrões de Prática Médica/estatística & dados numéricos , Cirurgia Bucal/educação , Humanos , Inquéritos e Questionários , Estados Unidos
19.
J Craniofac Surg ; 27(4): 846-56, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27152570

RESUMO

BACKGROUND: Limited outcome data exist regarding the survival of microvascular free flaps for head and neck reconstruction in children. The objectives of this study were to perform a systematic review of the literature and meta-analysis comparing the survival of the most commonly used free flaps used for head and neck reconstruction in children. METHODS: A systematic search of PubMed, Embase, and Scopus was conducted using various keywords up to January 1, 2015. Meta-analysis was used to compare the survival of the most commonly used free flaps. The primary predictor variable was free flap type. The primary outcome variable was flap failure. The pooled relative risk (RR) with 95% confidence intervals (CIs) was estimated using a Mantel-Haenszel, fixed-effects model. RESULTS: The authors reviewed 25,303 abstracts. Five studies met inclusion criteria. A total of 646 children received a total of 694 free flaps. The pooled survival rate among all free flaps was 96.4%. The fibula free flap (fibula) and subscapular system free flaps (scapula) were the most commonly used flaps. There was no difference in survival when comparing the scapula (RR = 0.59, 95% CI: 0.26, 1.56, P = 0.29), or fibula (RR = 1.91, 95% CI: 0.55, 6.65, P = 0.31) to other free flaps, or when comparing the scapula to the fibula (RR = 2.29; 95% CI: 0.40, 13.08, P = 0.35). CONCLUSIONS: Free tissue transfer is highly successful in children. Although data are limited, there appears to be no difference in survival among various free flaps used for head and neck reconstruction in children.


Assuntos
Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Criança , Fíbula/transplante , Sobrevivência de Enxerto , Humanos , Escápula/transplante
20.
Fish Physiol Biochem ; 42(1): 203-17, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26364216

RESUMO

The impact of replacing circa 70% fish oil (FO) by a vegetable oil (VO) blend (rapeseed, linseed, palm oils; 20:50:30) in diets for European sea bass juveniles (IBW 96 ± 0.8 g) was evaluated in terms of activities of digestive enzymes (amylase, lipase, alkaline phosphatase, trypsin and total alkaline proteases) in the anterior (AI) and posterior (PI) intestine and tissue morphology (pyloric caeca-PC, AI, PI, distal intestine-DI and liver). For that purpose, fish were fed the experimental diets for 36 days and then liver and intestine were sampled at 2, 6 and 24 h after the last meal. Alkaline protease characterization was also done in AI and PI at 6 h post-feeding. Dietary VO promoted higher alkaline phosphatase activity at 2 h post-feeding in the AI and at all sampling points in the PI. Total alkaline protease activity was higher at 6 h post-feeding in the PI of fish fed the FO diet. Identical number of bands was observed in zymograms of alkaline proteases of fish fed both diets. No alterations in the histomorphology of PC, AI, PI or DI were noticed in fish fed the VO diets, while in the liver a tendency towards increased hepatocyte vacuolization due to lipid accumulation was observed. Overall, and with the exception of a higher intestine alkaline phosphatase activity, 70% FO replacement by a VO blend in diets for European sea bass resulted in no distinctive alterations on the postprandial pattern of digestive enzyme activities and intestine histomorphology.


Assuntos
Bass , Gorduras na Dieta/farmacologia , Proteínas de Peixes/metabolismo , Hidrolases/metabolismo , Intestinos/enzimologia , Fígado/enzimologia , Animais , Ácidos Graxos Monoinsaturados , Óleos de Peixe/farmacologia , Intestinos/anatomia & histologia , Óleo de Semente do Linho/farmacologia , Fígado/patologia , Óleo de Palmeira , Óleos de Plantas/farmacologia , Período Pós-Prandial/fisiologia , Óleo de Brassica napus
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